During pregnancy, many women have lots of questions and queries. Some of them we ask our moms, our aunts, our friends, our colleagues, and some of us go to Facebook to seek answers . But, when does it become obvious that you need to call your doctor or midwife, or visit the health center immediately?
Dr. Stephen Mutiso, a consultant obstetrician/gynaecologist at KNH is our guest writer today and he lets us in on the warning signs –when a pregnant woman should seek a medic’s opinion as soon as possible.
*Antenatal care entails monthly visits to the clinic till 28 weeks gestation, then visits every two weekstill 36 weeks, and thereafter weekly visits till delivery –for those progressing well. However, sometimes there is variation from this schedule, and this depends on the needs of the expectant mother.
However there are certain situations when it becomes necessary to get in touch with your gynaecologist on an urgent basis before the next visit. This is especially when certain complications develop.
Complications during pregnancy and childbirth are common. Infact, approximately two out of every five pregnant women experience some complication during pregnancy, childbirth and postpartum period. 15 percent of pregnant women develop life-threatening complications. Most complications cannot be predicted and can happen at any point during the antenatal period, during delivery or post-delivery. Therefore, all pregnant women should be prepared to respond appropriately when complications arise by contacting their care givers immediately.
There are certain symptoms which if present denote that they could be serious complications hence need to act immediately. These symptoms are referred as danger signs. Knowledge of danger signs of pregnancy emergencies and appreciation of the need for rapid and appropriate response when they occur is important to avert fatal outcomes. At times, getting medical help early makes the difference between survival and death.
The danger signs in pregnancy are: vaginal bleeding, severe headache, severe vomiting, swelling of hands and face, difficulty in breathing, fits, fever, reduction or absent fetal movements, gush of fluid, intense abdominal pain and contractions before 37 weeks. Danger signs indicate a woman needs immediate medical care.
Bleeding is a very serious complication. It causes most of the maternal and foetal deaths in Kenya. Any bleeding in pregnancy –irrespective of the amount is abnormal. When bleeding is present during pregnancy it may indicate that the placenta position is on the lower aspect of the womb (placenta praevia). Bleeding may also occur when there is premature separation of the placenta. This premature separation cuts off delivery of oxygen and other nutrients to the baby, and this could lead to the baby’s death. Other causes of bleeding in pregnancy include: rupture of the uterus and bleeding from the baby (though this is rare). Heavy bleeding after delivery may arise from different causes such as relaxation of the uterus (atony), injuries in the birth canal, incomplete expulsion of placenta and sometimes bleeding disorders.
Severe headache, swelling of hands and face, blurred vision, fits and difficulty in breathing indicate high blood pressure and need urgent attention. This complication is referred to as severe preeclampsia, and when fits are present it is called eclampsia. This disease is also deadly and delivery is the way out regardless of whether the baby is mature or not. Seekng immediate care from your gynaecologist is important.
Hotness of the body with or without vomiting may indicate presence of serious infection or malaria. Prompt treatment does save life.
When waters break it is important to call your doctor immediately, because there is a possibility that the baby’s cord can come out and get compressed by the baby’s head, thereby stopping blood supply to the baby. This can cause death of the baby. It is also very easy for infection in the uterus to set in once the waters break. This infection is life threatening. Urgent care is therefore crucial.
Pregnant mothers should be keen on foetal movements (kicks) throughout their pregnancy. Any decrease in baby’s movement may indicate that all may not be well with the baby, and so it is important for the woman to report this observation to her gynaecologist as soon as possible.
Intense abdominal pains require urgent evaluation by your doctor. Causes of severe abdominal pain include ectopic pregnancy; rupture of uterus, premature separation, infection of the kidney. At times, abdominal pain may be due to surgical diseases such as appendicitis, intestinal obstruction etc.
Contractions which occur before 37 weeks indicate premature labour. Babies born at this time could develop breathing difficulties which sometimes could prove fatal. Its advisable for expectant women to seek assistance when they start getting regular uterine contractions especially if there are more frequently than 10 minutes apart.
In conclusion, knowledge of danger signs is important because it improves complication recognition and ensures timely decision to seek care hence handling complications in good time and consequently saving lives and avoiding serious disabilities.*
Dr. Stephen Mutiso is based at the KNH Doctor’s Plaza, Suite 26/27. He provides a wide range of gynaecological services including: antenatal care, delivery (normal and caesarean), infertility treatment, fibroids, fistula surgery, screening for reproductive tract cancers and various gynaecological operations.
Tel: 0722 678 002 or 0788 306 674
Website: drmutiso.com Email: firstname.lastname@example.org